Hi Bill;
I'm relatively new at this, but I think consulting the Rad Onc is a good
idea. I don't believe that the biopsy is required in order to do RT on the
bed. In my case I will be getting 5 weeks of IMRT on the areas surrounding
the Prostate before I get a Theraseed implant. My Rad Onc has already shown
me how he will map the area around the Prostate for the radiation and it's
all done with scans, x-rays and the computer - no biopsy necessary. The fact
that you had RP and I won't may change how the RT is done - but I don't see
how. Hang in there for some more experienced advise from the group - and
good luck.
Age - 68
8/12/02 - PSA 3.7
10/13/03 - PSA 4.69
11/11/03 - PSA 4.8
11/18/03 - Biopsy - 10 cores
one core-25% of core-Gleason 4+4=8
all other cores benign tissue
12/10/03 - Consult - Oncologist
12/16/03 - Consult - Radiation Oncologist
Treatment Plan -
HT - started 12/17/03 - Eulixen & Lupron
Radiation - IMRT to begin 3/14/04 - for 5 weeks
Theraseed implant after Radiation completed

Hi, Bill....

I agree with you.... I'd want to see a rad onc and pursue radiation of the
prostate bed right away.  *IF* the PSA doesn't come down afterwards, then
hit it with HT.  This seems to be the path most people have followed in such
cases.  Others with more experience here will be able to share more details,
I'm sure.

Hang in there!  And lean on us if you need a place to vent!

MikeH

I am not a doctor, but, for the life of me, I cannot imagine where a doctor
would probe in a biopsy if the suspect mass too tinier than what the
computer can see in a Prostascint Scan.

Hi Bill,

This is my story.

I was at .3  and it was 3 months after my RP. - 6 weeks after my RP I was at
<0.1

Many Doctors and some of the leading specialist in the US thought the cancer
spread from the bed since it returned so quickly. Some suggested going on HT
and Sloan Kettering told me they have never seen a case where radiation
worked when the psa came back so quickly and it would be best to go on HT. I
called them one day to tell them that my psa dropped to <0.01 after
radiation. They never returned my call.

Anyway, I did the research and I opted for IMRT. My psa is now <0.01

I would see a Rad Oncologist.

I have read that it is best to get the salvage radiation done when your PSA
is below .6 for best results. I went in at .3  Research states the lower the
better. My dose was 68,400 gy. My uro stated that 68-72 was the range that
would be effective - the more the better. My Rad Onc stated that he would
only give my 68,400. Research states that anything above 64 gy is
appropriate for Salvage Radiation. I would of opted for 72+ if it was my
decision. I trusted the Doc and took the 68gy. My Uro wanted me to take HT
before radiation. I had the HT pills and was scheduled to get the shot.
Amazingly I never followed through with the HT and just got the radiation. I
was so pissed off and dejected at the time and being a health nut I decided
to fight this disease on my own terms. My Rad Onc wasn't all that enthused
about HT either with salvage radiation anyway. He stated that their wasn't
enough research on it and if the cancer was in the IMRT zone then there
would be a 95% chance of a cure/success. If my Rad Onc wanted me to do the
HT I definetly would have.

I had a positive margin. PSA was 4.8 before RP and my gleason was 3+4, 47
yrs old.

It was my last ditch attempt before HT. I give thanks to God for it working
and pray daily that it remains at <0.01  I believe that the radiation got
all of the cancer and if there is anything remaining my immune system will
get the rest or at least hold it at bay. I am working daily on strenghening
my immune system

You never know whats going to happen, it may seem like your down and out
when in reality your one treatment away from winning -so keep the faith. You
can beat this thing.

I will pray for you. It can work. Nobody on earth knows at this time if it
has spread. Your Rad Onc Dr will explain everything.

Wishing you the best.

Dave P